The impact of death and dying on nursing students: an explanatory model

Aims and objectives. To explore nursing students' experiences of death and dying in clinical practice. Background. The encounter with death constitutes one of the most stressful experiences reported by nursing students during their clinical training. In particular, it can be difficult for student nurses to cope with the patient's suffering, to provide postmortem care and to communicate with the patient and his/her family as death approaches. Although some research has been carried out in relation to this phenomenon, there remains a need to identify and understand the situations and experiences that are of most concern to students, those which may affect their ability to cope and, therefore, interfere with the care they are able to offer to the dying patient and his/her family. Design. Qualitative descriptive and hermeneutic study. Methods. Semi-structured interviews (n = 12) were conducted with nursing students. Data were collected in 2012-2013. Transcripts were analysed using Colaizzi's seven-step procedure. Findings. The analysis identified five themes: impact, training in end-of-life care, ethical issues, coping and learning/growth/healing connections. The central theme was the enormous impact the encounter with death had, while the other themes were a response to and/or modulators of this impact. An explanatory model was derived on the basis of the relationship between all these emergent themes. Conclusions. It is essential to understand nursing students' experience of death so as to minimise its impact. The explanatory model described here could be a useful tool for the design of training programmes on end-of-life care. Relevance to clinical practice. Adequate training of this kind would help to ensure that future nurses offer high-quality care to patients and their families, minimising the impact of death and preventing emotional fatigue.